Endovascular Embolisation of Visceral Artery Pseudoaneurysms

Abstract

Objective. To evaluate the technical success, safety, and outcome of endovascular embolization procedure in management of visceral artery pseudoaneurysms. Materials and Methods. 46 patients were treated for 53 visceral pseudoaneurysms at our institution. Preliminary diagnostic workup in all cases was performed by contrast enhanced abdominal CT scan and/or duplex ultrasound. In all patients, embolization was performed as per the standard departmental protocol. For data collection, medical records and radiology reports of all patients were retrospectively reviewed. Technical success, safety, and outcome of the procedure were analyzed. Results. Out of 46 patients, 13 were females and 33 were males. Mean patient age was 44.79 ± 13.9 years and mean pseudoaneurysm size was 35 ± 19.5 mm. Technical success rate for endovascular visceral pseudoaneurysm coiling was 93.47% (n = 43). Complication rate was 6.52% (n = 3). Followup was done for a mean duration of 21 ± 1.6 months (0.5–69 months). Complete resolution of symptoms or improvement in clinical condition was seen in 36 patients (80%) out of those 45 in whom procedure was technically successful. Conclusion. Results of embolization of visceral artery pseudoaneurysms with coils at our center showed high success rate and good short term outcome.

Pseudoaneurysm Endovascular Treatment of a Middle Colic Arterial Branch in a Patient with an Intermittent Digestive Hemorrhage from an Obscure Source: Case Report

“…Endovascular management is safe and effective, including fewer complications, shorter hospital stay and recovery [4,18,19]. There are various methods for endovascular treatment, including the placement of coils, stent implantation, injection of polyvinyl alcohol particles, gelfoam or glue, and endoluminal thrombin injection [4,20,21]. Complications from these procedures are related to femoral cannulation, visceral infarction, abscess, organ necrosis, inadvertent and incorrect occlusion of a vessel, coil migration to other branches, infection or aneurysmatic rupture during embolization [9].…”

“…Conversely, pseudoaneurysms must be immediately treated as the rupture rate is much greater than true aneurysms (76.3% versus 3.1%) [11,17]. Endovascular management is safe and effective, including fewer complications, shorter hospital stay and recovery [4,18,19]. There are various methods for endovascular treatment, including the placement of coils, stent implantation, injection of polyvinyl alcohol particles, gelfoam or glue, and endoluminal thrombin injection [4,20,21].…”

“…Through the development of new techniques of minimally invasive intervention and the increased experience of endovascular surgeons, traditional treatment concepts have changed [4]. Herein, we describe a rare case of pseudoaneurysm of the middle colic artery branch responsible for the intermittent digestive hemorrhage condition from an obscure source, diagnosed and successively treated by endovascular technique.…”

Migration of Glue Cast into Biliary System Following Embolisation of a Mycotic Pseudoaneurysm of the Hepatic Artery

“…Other treatment options include direct imaging-guided percutaneous thrombin injection and endovascular-covered stent placement. 2,3 Embolisation should be performed superselectively to avoid non-target embolisation or liver necrosis. As the pseudoaneurysm is weak, any forceful injection during superselective catheterisation may lead to rupture and thus caution is needed.…”

Investigating of the Usefulness of Multidetector-row Computed Tomography for Diagnosing Abdominal Visceral Pseudoaneurysms

“…However, very few reports have summarized the diagnostic usefulness of MDCT in cases of abdominal visceral pseudoaneurysms. Even cases of potentially fatal condition of visceral pseudoaneurysms may progress favorably if percutaneous vascular embolization is quickly and successfully performed [9][10][11][12] .…”